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Allergic Rhinitis

Symptoms of Allergic Rhinits
Common Allergens
Persistent Sneezing
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Allergic Rhinitis: Symptoms, Assessment, and Management

Updated: 11 Feb 2026 Reviewed by Dr Dennis Chua

Key takeaways

  • Allergic rhinitis is caused by an allergic reaction to airborne allergens such as dust mites, pollen, mould, or pet dander, leading to inflammation of the nasal lining, with symptoms like sneezing, a runny or blocked nose, nasal itching, post-nasal drip, and watery or itchy eyes.
  • Symptoms may vary in severity and frequency, and can be seasonal or persistent, depending on the type of allergen exposure. Ongoing nasal inflammation may affect sleep quality, concentration, and daily activities.
  • Assessment typically involves a clinical evaluation to identify symptom patterns, triggers, and contributing factors.
  • Management depends on symptom severity and individual response, including avoidance of known triggers, medications such as antihistamines or nasal sprays, and other supportive measures.
  • Assessment by an ENT specialist may be considered when symptoms are persistent, recurrent, or inadequately controlled, to confirm the diagnosis and guide appropriate management.
View the full summary text

Allergic rhinitis is a condition caused by an allergic reaction to airborne allergens such as dust mites, pollen, mould, or pet dander, leading to inflammation of the nasal lining. Common symptoms include sneezing, a runny or blocked nose, nasal itching, post-nasal drip, and watery or itchy eyes.

Symptoms may vary in severity and frequency, and can be seasonal or persistent, depending on the type of allergen exposure. Ongoing nasal inflammation may affect sleep quality, concentration, and daily activities. Assessment typically involves a clinical evaluation to identify symptom patterns, triggers, and contributing factors.

Management of allergic rhinitis depends on symptom severity and individual response, including avoidance of known triggers, medications such as antihistamines or nasal sprays, and other supportive measures. Assessment by an ENT specialist may be considered when symptoms are persistent, recurrent, or inadequately controlled, to confirm the diagnosis and guide appropriate management.

This summary is for general education and does not replace personalised medical advice.

What is Allergic Rhinitis (Hay Fever)?

Allergic rhinitis impacts millions of people worldwide. In Singapore, this condition is particularly prevalent, affecting 13.1% of the population due to the nation’s tropical climate and high humidity levels. The incidence is even higher among children, making it essential to seek advice from an ENT specialist in Singapore.

The term “hay fever” came about due to an early misconception in the 1800s that the smell of new hay brought about the onset of allergic rhinitis symptoms.

Allergic rhinitis is inflammation in the nose that happens when the body’s immune system overreacts to allergens in the air. Everyday things like house dust easily trigger these allergic symptoms.

What Are the Symptoms of Allergic Rhinitis?

Common symptoms of allergic rhinitis include:

  • Sneezing
  • Runny or stuffy nose
  • Itchy or watery eyes
  • Postnasal drip
  • Coughing
  • Fatigue

Some patients even report negative effects on their sleep.

Allergic rhinitis is a common condition managed in an ENT clinic in Singapore clinic. If you wish to consult an ENT specialist in Singapore, our clinic provides assessment and treatment tailored to your needs.

What Are the Common Causes of Allergic Rhinitis?

A combination of environmental triggers, genetic predisposition, and lifestyle factors often cause allergic rhinitis. 

  • Allergens such as pollen, dust mites, mould spores, and pet dander are some of the  primary causes of allergic rhinitis. 
  • Genetic factors can also play a role in an individual’s likelihood to develop allergic rhinitis, for instance, if one or both parents have allergies. 
  • Poor air quality, including pollution and tobacco smoke, can also worsen nasal congestion and irritation.
  • Certain foods, such as dairy products, foods high in histamine, seafood, and nuts and seeds, can also exacerbate symptoms.

If you think you might have allergic rhinitis, obtaining a medical diagnosis is essential. An ENT specialist will conduct a comprehensive assessment and may suggest allergy testing to pinpoint the specific allergens causing your symptoms. 

How to Prevent or Minimise Allergic Rhinitis Symptoms

While allergic rhinitis cannot be cured completely, there are several strategies to manage symptoms effectively. 

Identify and Avoid Triggers. Understanding your triggers is the first step in managing allergic rhinitis. In Singapore, common allergens include:

  • Dust Mites: Wash bedding weekly in hot water, vacuum carpets frequently, and use dust-proof covers on mattresses and pillows.
  • Mould: Minimise indoor humidity using dehumidifiers and regularly clean damp areas, such as bathrooms and kitchens.
  • Pet Dander: If you’re sensitive to pets, groom them regularly and keep them out of bedrooms or furniture-heavy areas.

Over-the-Counter Remedies. Medications can provide quick relief for allergic rhinitis symptoms, such as:

  • Antihistamines: These medications block the effects of histamines, reducing sneezing, itching, and runny nose.
  • Nasal Sprays: TCorticosteroid sprays are highly effective for reducing inflammation and nasal congestion when used consistently.
  • Decongestants: These offer temporary relief from stuffy noses but should not be used for prolonged periods due to potential side effects.

Small changes in your living environment in Singapore can significantly reduce exposure to these triggers and lessen your symptoms.

Effectively managing allergic rhinitis involves a blend of treatment interventions and lifestyle adjustments. Some patients turn to pharmacological treatments, while others want to explore natural remedies for allergic rhinitis.

Immunotherapy is another treatment option, which works by gradually desensitising the immune system to specific allergens. It aims to reduce or even eliminate allergic reactions over time. It is administered either as injections under the skin (subcutaneous immunotherapy or SCIT) or drops or tablets under the tongue (sublingual immunotherapy or SLIT). 

More importantly, avoiding common allergens can prevent the onset of allergic rhinitis.

Dr Dennis Chua - ENT Specialist Singapore - Avoiding Common Allergens

How to Check if It’s Allergic Rhinitis

Properly identifying symptoms of allergic rhinitis is crucial in its treatment. How is the condition different from the common cold or COVID-19? Read more here.

Consider these key differences:

  • Allergies: Typically accompanied by itchy eyes, sneezing, and nasal congestion. Symptoms are triggered by exposure to allergens like pollen, dust, or pet dander.
  • Common Cold: Usually begins with a sore throat. After that, the patient may experience a runny or stuffy nose and a mild fever. Symptoms generally clear up within a week.
  • COVID-19: Presents a wider range of symptoms, including high fever, persistent cough, and extreme fatigue. A unique symptom is the loss of taste or smell.

Our clinic offers care for patients with allergic rhinitis and other related conditions. You may visit our ENT clinic in Singapore clinic or arrange a consultation with an ENT specialist in Singapore for further evaluation.

When to See an ENT Specialist for Allergic Rhinitis in Singapore

Consider seeing an ENT specialist if your allergic rhinitis symptoms are persistent, frequently return or continue to affect your sleep, concentration or daily activities despite avoiding known triggers and using regular treatment.

An ENT assessment may also be appropriate if you experience:

  • ongoing or severe nasal blockage;
  • recurrent sinus infections;
  • reduced sense of smell;
  • frequent nosebleeds;
  • snoring or disturbed sleep;
  • ear pressure, blocked ears or hearing changes; or
  • uncertainty about whether your symptoms are caused by allergies or another nasal condition.

The ENT specialist may examine the inside of the nose and assess for contributing conditions such as enlarged turbinates, nasal polyps, sinus inflammation or a deviated nasal septum. Allergy testing or further investigations may be discussed when clinically appropriate. Treatment will depend on the cause, severity and effect of the symptoms on your daily life.

Allergic Rhinitis vs Sinusitis — What's the Difference?

“I think I have sinus problems” is one of the most common things patients say when they walk into our clinic. In Singapore, the word “sinus” is often used loosely to describe any nasal discomfort — but in clinical terms, allergic rhinitis and sinusitis are distinct conditions that require different approaches to management. Knowing the difference can help you seek the right treatment sooner.

A Side-by-Side Comparison

Allergic RhinitisSinusitis
What causes it?What causes it?
An overreaction of the immune system to airborne allergens such as house dust mites, mould, pet dander or pollenInflammation or infection of the sinus cavities, often following a viral upper respiratory tract infection or as a complication of untreated allergic rhinitis
Nasal dischargeNasal discharge
Typically clear and watery — a hallmark of allergic rhinitis that helps distinguish it from infectionOften thick and discoloured (yellow or green), indicating bacterial involvement or significant inflammation
Duration & patternDuration & pattern
Symptoms flare with allergen exposure and may improve when away from the trigger. Perennial rhinitis (year-round) is common in Singapore due to its environment.Sinusitis can be acute (typically lasting up to 4 weeks) or chronic (persisting beyond 12 weeks). Symptoms may worsen progressively rather than fluctuating with allergen exposure.
Facial pain or pressureFacial pain or pressure
Facial pressure is uncommon. Symptoms are primarily centred on nasal itching, sneezing, and eye irritation.Facial pain or pressure — particularly over the cheeks, forehead, or around the eyes — is a characteristic feature. Pain may worsen when bending forward.
FeverFever
No fever. Allergic rhinitis is an immune reaction, not an infection.Fever may be present, particularly in acute bacterial sinusitis.
Eye symptomsEye symptoms
Itchy, watery or red eyes are common alongside nasal symptoms (allergic rhinoconjunctivitis).Eye symptoms are less typical unless there is significant orbital involvement.
First-line treatmentFirst-line treatment
Antihistamines and intranasal corticosteroid sprays, combined with allergen avoidance strategies.Saline irrigation, decongestants, and antibiotics where bacterial infection is confirmed. Intranasal steroids may be added for inflammation.

Can You Have Both at the Same Time?

Yes — and this is common. Chronic allergic rhinitis is a recognised risk factor for developing sinusitis. Persistent nasal inflammation from allergic rhinitis can impair drainage of the sinuses, creating conditions favourable for secondary infection or chronic inflammation. This is why ENT specialists assess both the nasal mucosa and the sinuses when evaluating patients with persistent nasal symptoms.

When to See a Doctor

If you have had a blocked or runny nose for more than 10 days with discoloured discharge, facial pain, or a persistent low-grade fever, you may have sinusitis rather than (or in addition to) allergic rhinitis. A clinical assessment — including nasal endoscopy where indicated — can help determine the correct diagnosis and appropriate treatment plan.

Perennial Allergic Rhinitis vs Seasonal Allergic Rhinitis

Perennial and seasonal allergic rhinitis differ primarily in their triggers and duration. Perennial allergic rhinitis occurs year-round and is typically triggered by indoor allergens, such as mould, pet dander, and dust mites. On the other hand, seasonal allergic rhinitis happens during particular times of the year when pollen from trees, grass, and weeds are more prevalent.

Understanding the differences between perennial and seasonal allergic rhinitis is crucial. Perennial allergic rhinitis results in chronic symptoms due to continuous exposure to indoor allergens, while seasonal allergic rhinitis symptoms are intermittent and aligned with pollen seasons. Chronic allergic rhinitis typically lasts longer than 12 weeks, compared to acute allergic rhinitis, which lasts a few days or up to four weeks.

Allergic Rhinitis in Children

Allergic rhinitis is one of the most common chronic conditions in Singapore children. According to SingHealth, approximately one in two children in Singapore is affected, with the prevalence of allergic rhinitis in school-age children going up to 40%. In younger children, the condition frequently goes unrecognised — often mistaken for repeated colds, or attributed to teething — which can lead to delayed diagnosis and unnecessary interventions.

How Does It Present Differently in Children vs Adults?

In adults, allergic rhinitis typically presents with the classic cluster of sneezing, a runny nose, nasal congestion, and itchy, watery eyes. In children, however, the picture can be less straightforward. While these symptoms do occur, children with allergic rhinitis may also present with:

▸  Frequent mouth breathing, snoring, or restless sleep  common when nasal congestion is persistent

▸  The “allergic salute” — a habitual upward wiping of the nose with the palm of the hand, which can cause a characteristic crease across the nose

▸  “Allergic shiners” — dark circles or puffiness under the eyes caused by congestion-related venous pooling

▸  Recurrent ear infections or hearing difficulties  allergic rhinitis can contribute to Eustachian tube dysfunction and fluid build-up in the middle ear

▸  Frequent headaches or early morning stomach discomfort from swallowed post-nasal drip

▸  Teeth grinding, malalignment of teeth, or recurrent mouth ulcers from chronic mouth breathing

▸  Inattentiveness at school  often overlooked as a potential sign of uncontrolled rhinitis

As highlighted by Singapore Medical Journal (2024) guidelines on primary care management of allergic rhinitis in children, many of these symptoms are not typically associated with rhinitis in the clinical setting. As a result, children often undergo unnecessary testing and treatment without improvement — unless the underlying allergic condition is identified and managed appropriately.

How Allergic Rhinitis Affects a Child's Quality of Life

Uncontrolled allergic rhinitis in children goes beyond a runny nose. Research and Singapore-based clinical guidance point to a meaningful impact on daily functioning:

Area of ImpactHow Allergic Rhinitis Affects ItSigns to Watch For
SleepNasal congestion at night causes disrupted sleep, frequent awakenings, and non-restorative rest. Chronic sleep disruption in children can affect growth, mood and behaviour.Poor sleep, snoring, fatigue
SchoolDaytime sleepiness and difficulty concentrating are common consequences of poorly controlled rhinitis. Some children are misidentified as inattentive or disengaged.Academic underperformance, attention difficulties
Physical activityNasal obstruction and fatigue can reduce a child's capacity and willingness to engage in sports or play.Exercise avoidance, reduced activity
Emotional wellbeingChronic symptoms, disturbed sleep and the social visibility of symptoms (e.g. constant sniffling) can affect a child's self-esteem and social confidence.Anxiety, reduced self-confidence

Is It Safe for Children to Use Nasal Sprays or Antihistamines?

This is one of the most common questions parents ask. The short answer is: yes, when used appropriately and under medical guidance. Here is what Singapore guidelines and HSA-registered usage indicate:

Intranasal Corticosteroid Sprays (e.g. Mometasone, Budesonide)

Intranasal corticosteroid sprays are the first-line treatment for moderate-to-severe allergic rhinitis in children, as recommended by the ARIA guidelines adopted in Singapore. Clinical studies confirm that they are relatively safe in children and do not significantly influence long-term growth velocity at the doses used in nasal sprays. Common sprays available in Singapore that are approved for paediatric use include mometasone furoate (Nasonex™), budesonide (Rhinocort®) and triamcinolone acetonide (Nasacort®).

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Important: Proper technique must be taught to both the child and parent/caregiver to avoid contact with the nasal septum, which can cause nosebleeds. The dose should be tapered to the lowest effective dose once symptoms are controlled.

Antihistamines

Oral antihistamines are effective in relieving sneezing, runny nose and nasal itch. Second-generation antihistamines such as cetirizine and loratadine are generally preferred in children as they are less sedating than first-generation options like chlorpheniramine. However, parents should always check age-specific dosing guidelines and consult a healthcare professional before administering. The HSA advises seeking professional advice before giving any cough and cold preparation to children — particularly those under two years of age.

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Important: First-generation antihistamines (e.g. chlorpheniramine) can cause sedation and should be used with caution in school-going children as they may impair concentration and school performance.

Immunotherapy (for Children 5 Years and Older)

For children aged 5 and above whose symptoms remain uncontrolled despite medication and allergen avoidance, allergy immunotherapy — either as subcutaneous injections or sublingual tablets — may be considered. This is a 3-year course that progressively builds the immune system's tolerance to specific allergens. Referral to a specialist is recommended for these cases.

When Should Parents See an ENT Specialist?

Most mild cases of allergic rhinitis in children can be managed at the GP or polyclinic level. However, parents should consider seeking specialist assessment when:

▸  Symptoms persist or worsen despite using nasal sprays and antihistamines as prescribed

▸  The child experiences recurrent ear infections, hearing difficulties, or has been diagnosed with otitis media with effusion

▸  There is persistent mouth breathing, loud snoring, or observed pauses in breathing during sleep

▸  Symptoms significantly affect the child’s sleep quality, school performance, or daily activities

▸  The child has co-existing conditions such as asthma, eczema, or chronic sinusitis that complicate management

▸  Parents wish to discuss allergy testing (skin prick test) to identify specific triggers, or explore immunotherapy as a long-term option

Dr Dennis Chua

"As an ENT specialist, I often see children who have been struggling with persistent nasal congestion and repeated ear infections for months — sometimes years — before the connection to allergic rhinitis is made. Early recognition and proper management can make a significant difference to a child's sleep, concentration, and overall quality of life. An ENT assessment can help identify whether there are structural or allergic factors contributing to their condition."

How Allergic Rhinitis Affects Your Sleep

One of the most overlooked effects of allergic rhinitis is its impact on sleep. Many patients manage their daytime symptoms with medication but continue to struggle with restless nights, waking up feeling unrefreshed, and persistent daytime fatigue — without realising that their nasal condition is the cause.

During the day, nasal congestion is uncomfortable but manageable. At night, the same degree of congestion can significantly disrupt the quality of sleep. Several mechanisms are at play:

  • ▸ When lying down, blood flow to the nasal mucosa increases, causing additional swelling of the turbinates (the structures inside your nose that can enlarge during allergic reactions). This means nasal obstruction is often worse at night than during the day.
  • ▸ Congestion forces mouth breathing during sleep, which dries out the mouth and throat, increases snoring, and reduces sleep quality.
  • ▸ Histamine, which is released during an allergic reaction, has independent alerting effects on the brain and can suppress REM (deep) sleep, even in the absence of significant congestion.
  • ▸ Post-nasal drip — mucus running down the back of the throat — can trigger coughing or throat clearing during sleep, causing awakenings.

The ARIA guidelines, referenced in Singapore’s 2020 update on allergic rhinitis care pathways, classify sleep disturbance as one of the primary markers of moderate-to-severe allergic rhinitis, alongside impairment of daily activities and school or work performance. If your rhinitis is affecting your sleep, this is a signal to seek assessment and optimise your treatment.

The Link Between Allergic Rhinitis and Obstructive Sleep Apnea (OSA)

Allergic rhinitis and obstructive sleep apnea (OSA) often co-exist and can mutually worsen each other. Research indicates that individuals with persistent nasal congestion from allergy are approximately 1.8 times more likely to have moderate-to-severe sleep-disordered breathing compared to those without nasal congestion.

The mechanism is straightforward: chronic nasal obstruction leads to mouth breathing during sleep, which destabilises the upper airway and increases the likelihood of airway collapse. Inflammatory mediators associated with allergic rhinitis — including histamine, interleukins and leukotrienes — have also been shown to independently worsen sleep architecture.

What the Research Shows

Clinical studies have shown that treating allergic rhinitis with intranasal corticosteroids can improve sleep quality and reduce markers of obstructive sleep apnea in patients who have both conditions. Treating the nasal component first — before considering more invasive OSA interventions — is a principle that ENT specialists apply in practice.

If you have been told you snore heavily, or if a partner has observed pauses in your breathing during sleep, it is worth discussing this with an ENT specialist who can assess whether your nasal symptoms are contributing to a sleep-disordered breathing problem. Learn more about Obstructive Sleep Apnea and how it is assessed and managed at our clinic.

Practical Tips to Improve Sleep With Allergic Rhinitis

TipWhat to DoBest For
Elevate your headSleeping with your head elevated by 10–15 cm helps reduce nasal congestion by decreasing blood pooling in the nasal mucosa. Use a firm wedge pillow or raise the head end of the bed.Most effective for those whose symptoms worsen significantly when lying flat
Manage your bedroom environmentThe bedroom is the single most important space to allergen-proof. House dust mites — the leading trigger of allergic rhinitis in Singapore — thrive in mattresses, pillows, and bedding. Wash all bedding in hot water (above 60°C) at least once every one to two weeks, as recommended by SingHealth. Use allergen-proof mattress and pillow covers. Vacuum the mattress regularly, and keep soft toys and thick curtains to a minimum.Most impactful for patients allergic to house dust mites
Use a HEPA air purifierA high-efficiency particulate air (HEPA) purifier can reduce airborne allergens including dust mite particles, mould spores and pet dander within the bedroom. HEPA filters are recommended as part of allergen reduction strategies in Singapore clinical guidelines. Choose a unit appropriately sized for your bedroom and replace filters as per manufacturer instructions.Particularly useful in Singapore's humid, air-conditioned bedrooms where mould spores may accumulate
Keep bedroom windows closed at nightIn Singapore, keeping windows closed at night — especially during haze periods or when outdoor humidity is high — helps limit entry of outdoor particulate matter and mould spores that can worsen nasal symptoms during sleep.More important during haze season (typically August–October)
Time your nasal spray correctlyIf you use an intranasal corticosteroid spray, taking it in the evening (rather than only in the morning) can help reduce nasal inflammation before bedtime, improving overnight breathing.Consult your doctor before changing the timing of your medication
Clean air conditioning filtersAir conditioning units in Singapore are a common reservoir for mould spores. Clean the filter every 2–4 weeks, and service the unit regularly to prevent mould accumulation.Important year-round given Singapore's continuous air-conditioning usage

Singapore’s tropical climate, high humidity, and unique urban environment make it one of the more challenging places in the world to manage allergic rhinitis. Understanding the local triggers — and how to reduce your exposure to them — is a critical part of getting symptoms under control.

Haze Season: A Singapore-Specific Trigger

Unlike many temperate countries where allergic rhinitis is seasonal and driven by pollen, Singapore experiences year-round perennial allergic rhinitis, primarily triggered by indoor allergens like house dust mites. However, Singapore also faces recurring haze events — typically between August and October — caused by transboundary forest and peat fires in the region. These events introduce large quantities of fine particulate matter (PM2.5) into the air, which can significantly worsen rhinitis symptoms.

As noted by the National Environment Agency (NEA) and the Ministry of Health (MOH), Singapore residents can monitor air quality using the Pollutant Standards Index (PSI), published hourly at haze.gov.sg. A PSI reading above 100 is considered unhealthy, and rhinitis patients should be particularly cautious as their nasal lining is already sensitised and more reactive to particulate irritants than the general population.

PSI ReadingAir Quality LevelGuidance for Rhinitis Patients
0–50GoodNormal activities — no restrictions needed
51–100ModerateSlight drop in visibility; rhinitis patients may notice mild symptom increase
101–200UnhealthyStay indoors where possible. Close windows. Use an air purifier if available. Rhinitis flares likely.
201–300Very unhealthyRemain indoors. Wear a mask (N95) outdoors. Continue nasal spray and antihistamines as prescribed.
301+HazardousAvoid all outdoor activity. Seek medical attention if symptoms are severe or breathing is significantly affected.

MOH Haze Advice for Rhinitis Patients

Stay indoors where possible. Close windows and doors. Use a portable HEPA air purifier to reduce indoor particle levels. Clean air conditioning filters and ensure units are in good working condition. Drink plenty of fluids. Use saline nasal rinses to remove particulate matter from the nasal passages. Continue prescribed nasal sprays and antihistamines as directed by your doctor.

HDB and Condo Living: Dust Mites in a Humid Climate

House dust mites are the most common allergen trigger in Singapore, far more prevalent than pollen. The warm, humid climate — with relative humidity often exceeding 80% — creates near-ideal conditions for dust mite proliferation. Dust mites thrive in mattresses, pillows, upholstered furniture, carpets, and soft toys, feeding on shed human skin cells.

For residents in HDB flats and condominiums — where most Singaporeans live — a few practical home management steps, aligned with SingHealth and Singapore Medical Journal guidelines, can make a meaningful difference:

▸  Wash bedsheets, pillowcases and covers in hot water above 60°C at least every one to two weeks. This temperature is required to kill dust mites effectively.  SingHealth-recommended threshold

▸  Use allergen-proof impermeable covers on mattresses and pillows, replacing them every one to two years.

▸  Vacuum mattresses and soft furnishings regularly. Ensure your child (or any allergic household member) is out of the room while vacuuming, and allow dust to settle for approximately two hours before re-entry.

▸  Minimise carpeting, thick curtains, and upholstered furniture in bedrooms where feasible.

▸  Keep indoor relative humidity below 60% where possible, using air conditioning or a dehumidifier, as dust mites cannot survive in low-humidity environments.

▸  Avoid placing soft toys on beds. Wash them weekly in hot water or freeze them for 24 hours to kill mites.

Air Conditioning and Mould Spores

Air conditioning is a staple of life in Singapore — most homes, offices, and schools run their units continuously. While air conditioning does help reduce indoor humidity (which suppresses dust mite growth), poorly maintained units become reservoirs for mould spores, another significant allergen for rhinitis sufferers.

Mould thrives in the dark, damp internal components of air conditioning systems. When the unit runs, mould spores are distributed throughout the room. Patients who notice their rhinitis worsens at home but improves in other environments — or who experience symptoms primarily at night — should consider their air conditioning unit as a potential source.

▸  Clean the air filter every two to four weeks and service the unit professionally at least once or twice a year.

▸  After servicing, run the unit on fan-only mode for 30 minutes before using air conditioning to clear any residual cleaning agents.

▸  Check for visible mould around air conditioning vents and clean promptly.

▸  If mould contamination is significant, professional duct cleaning may be warranted.

Choosing an Air Purifier for a Singapore Home

For rhinitis patients, an air purifier with a HEPA (High-Efficiency Particulate Air) filter is recommended. HEPA filtration — at the H13 or H14 standard — captures 99.95% or more of airborne particles, including dust mite allergen fragments, mould spores, and PM2.5 particles from haze. Some units also include an activated carbon layer to absorb chemical irritants such as volatile organic compounds.

What to Look For in an Air Purifier

▸ HEPA filter (H13 standard or above) captures PM0.1 and above at ≥99.95% efficiency
▸ CADR (Clean Air Delivery Rate) appropriate for the room size for a standard Singapore bedroom of ~15–20 sqm, aim for CADR of at least 150 m³/hr
▸ Low noise levels for overnight operation look for <30 dB at the lowest setting
▸ Filter replacement indicator HEPA filters need replacement every 6–12 months depending on use and Singapore air quality conditions
Note: Air purifiers are a supportive measure — they do not replace allergen avoidance strategies or medical treatment.

Why See an ENT Specialist for Allergic Rhinitis?

For many patients, allergic rhinitis starts at a GP or polyclinic — and that is entirely appropriate for mild cases. Most patients will benefit from first-line management with antihistamines, nasal sprays, and allergen avoidance guidance, which can be prescribed at the primary care level.

However, when symptoms are persistent, recurrent, or not adequately controlled despite appropriate treatment, a specialist assessment by an Ear, Nose and Throat (ENT) surgeon can provide a level of diagnostic detail and treatment breadth that primary care is not equipped to offer.

What an ENT Specialist Can Offer That a GP Cannot

What We Assess / OfferWhy It Matters
Nasal EndoscopyA thin, flexible endoscope allows direct visual inspection of the nasal passages, turbinates, sinuses and post-nasal space. This can reveal structural issues (such as a deviated septum or enlarged inferior turbinates) that perpetuate nasal obstruction even after the allergic component is treated.
Skin Prick TestingA skin prick test identifies the specific allergens triggering your symptoms — from house dust mites and mould to pet dander and grass pollen. Knowing your triggers allows for targeted avoidance strategies and determines eligibility for immunotherapy.
ImmunotherapyFor patients who do not respond well to medication, or who wish to reduce long-term dependence on daily sprays and tablets, allergen immunotherapy — available as injections or sublingual drops/tablets — can be prescribed. This is a 3-year course that modifies the immune response itself, offering lasting relief after treatment completion.
Turbinate Reduction (Radiofrequency)In patients with persistent nasal congestion that does not fully respond to medication, a simple in-clinic procedure using radiofrequency energy can be used to reduce the size of the inferior turbinates. This can be performed under local anaesthesia with minimal downtime, and patients can typically return to work the same day.
Assessment of Related ConditionsENT specialists can simultaneously assess for conditions that commonly co-exist with allergic rhinitis — including sinusitis, nasal polyps, deviated septum, and obstructive sleep apnea — allowing for a comprehensive treatment plan rather than managing each condition in isolation.

Frequently Asked Questions About Allergic Rhinitis

Rhinitis Meaning - What is Allergic Rhinitis?

Allergic rhinitis is a very common condition of the nose and is commonly mistaken as “sinus” issues. Symptoms of allergic rhinitis include an itchy nose, stuffy nose, red or watery eyes, sneezing and swelling around the eye area.

Due to Singapore’s tropical climate and high humidity, allergic rhinitis is very common here. It is believed that 20% of the population may have this condition. Further, having symptoms of allergic rhinitis is higher in the paediatric group.

Patients of allergic rhinitis are extra sensitive to airborne allergens, which include things like house dust mites, molds, cat’s or dog’s dander or grass. Exposure to these allergens will trigger an allergic reaction which can offset a reaction within the nose resulting in blocked nose, runny nose and sneezing. One way to identify allergic rhinitis is the colour of the fluid from the nose — the fluid is often clear, unlike bacterial infections where the phlegm and nasal fluid is often coloured.

Allergic rhinitis has also been said to occur seasonally, mostly triggered when the pollen season commences. This is known as seasonal allergic rhinitis. Symptoms are the same as seasonal rhinitis.
Treatment includes nasal sprays and antihistamine tablets. For severe allergic rhinitis, an allergy test which involves the prick of the skin can be performed to see what the potential triggers are. However, key treatment for allergic rhinitis is to avoid allergens that trigger symptoms. For recalcitrant problematic cases of allergic rhinitis, nasal surgeries can be performed to improve nasal airflow.

Allergy testing can determine what specific allergens a patient is susceptible to. The most common way to do testing for allergic rhinitis is a skin prick test, otherwise known as a test.

This method tests for any form of immediate or delayed reaction to various allergens. Allergens that are commonly tested for in the case of allergic rhinitis include:

  • dog dander
  • cat dander
  • grass bollen
  • birch pollen
  • daisy pollen
  • feathers
  • dust mites

The back or forearm is usually picked as a site for the test to be administered. The doctor may also choose to use a patch test, which is similar. Allergens that are being tested for are usually indicated on the patient’s forearm using a black marker.

I will then carefully administer a certain amount of the allergen onto their respective markers using a special lancet. This may or may not trigger an allergic reaction which will then be measured and analyzed. Based on results and observation, I will decide whether or not the patient is susceptible to getting an allergic reaction from that allergen.

This is a painless test. At most, it feels like an ant bite from the tool that goes through the skin. There is no bleeding and most patients will tolerate it well. Results are obtained in 30 minutes.

Skin Prick Test
Picture of a patient’s forearm after a skin prick test.

The size of the bump is measured and the offending allergen is known.

While it can be difficult to completely avoid the allergen, there are several ways to reduce exposure from it. A good start is to vacuum your room every time you have allergic symptoms. The less you are exposed to common allergic triggers like dust mites, pollen, or animal dander, it is likely that symptoms that were once severe will become milder or disappear completely.

The first step is allergen avoidance. After an allergy test is done, nasal sprays will be given to help in the short term. A saline spray can help clean the nose of lodged with allergens and sinus cavities. A medicated nasal steroid spray is then used to help reduce inflammation in the nose. The nasal steroid spray is minimally absorbed in the systemic bloodstream and is very safe to use short term.
Antihistamine tablets will be prescribed as adjunctive treatment to help alleviate allergy symptoms such as nasal congestion, runny nose and sneezing. If you have a runny nose, Washing your face with hot water and regularly blowing your nose may provide some temporary relief.

Immunotherapy, otherwise known as allergy shots, are also a long term treatment for allergic rhinitis. Allergy shots containing allergens are injected into the body over 3-5 years to develop resistance.

Immunotherapy

Based on the skin prick test results, immunotherapy can sometimes be prescribed for patients who do not respond well to nasal sprays and tablets. Immunotherapy, otherwise known as allergy shots long term injections that send to send little bits of allergens into your system so that your body’s immune system becomes more resistant to them, making you less susceptible to allergic symptoms.

For ease of administration, immunotherapy is available in the form of sublingual tables too. As immunotherapy is a 3-year course, of long term commitment is required for a good outcome.

For patients who are still troubled by nasal congestion and other symptoms despite treatment, a simple procedure to reduce the size of the inferior turbinates (radiofrequency) can be performed. The inferior turbinate is a structure that is commonly enlarged during allergic rhinitis. This can be performed under local anaesthesia in the clinic. The downtime is not severe and patients can usually return straight to work after.

Dr Dennis Chua

Dr Dennis Chua

ENT Surgeon
ENT Surgeons Medical Centre

Dr Dennis Chua is a specialist in Ear, Nose and Throat (ENT) surgery based in Singapore, with a particular interest in nasal and sinus conditions including allergic rhinitis. He practises at Mount Elizabeth Orchard and Mount Elizabeth Novena Specialist Centre.

Dr Chua's approach to allergic rhinitis management is aligned with the ARIA (Allergic Rhinitis and its Impact on Asthma) care pathways, which form the basis of Singapore's current clinical guidelines for rhinitis management.

He takes a stepwise, evidence-based approach — starting with the least invasive interventions and escalating only where necessary.

ENT Specialist — Singapore

If you have questions or concerns about your ears, nose, and throat, you may book a consultation with Dr Dennis Chua, an ENT specialist in Singapore. He has completed his training in otorhinolaryngology locally and attained qualifications internationally.

Local Training International Qualifications Otorhinolaryngology
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Dr Dennis Chua, ENT Specialist, Mount Elizabeth Orchard & Novenas

"The majority of patients I see with allergic rhinitis achieve meaningful improvement in their symptoms within the first few weeks of starting appropriate treatment. For patients who have been managing their condition for years without adequate control, a proper assessment — including identifying specific allergens and assessing the nasal anatomy — often reveals a clear path forward for their ENT health."

ENT Specialist · Facial Plastic Surgeon

Dr. Dennis Chua

BOARD CERTIFICATION
Double Board Certified Facial Plastic & Reconstructive Surgeon (International & European Boards – IBCFPRS & EBCFPRS)

Qualifications

  • MBBS (Singapore)
  • MRCS (Edinburgh)
  • MMed (ORL)
  • FAMS (ORL)
  • IBCFPRS
  • EBCFPRS
Years experience
0
Awards received
0

Global

Conference speaker

A highly regarded ENT specialist with a fellowship at the University of Virginia under Professor Stephen Park (Past President, American Academy of Facial Plastics & Reconstructive Surgery). Previously Chief of Facial Plastics & Reconstructive Service at Tan Tock Seng Hospital and Honorary Secretary of the Singapore Society of Otolaryngology.

Trained in Da Vinci robotic ENT surgery in South Korea and serves as ENT Lead Tutor at Lee Kong Chian School of Medicine. Has presented at international conferences across America, China, Europe, and Southeast Asia.

Notable awards

2013 Health Manpower Development Award — Ministry of Health
2011 Service with a Heart Award
2009 Singhealth Best Doctor Award
2009 Best Oral Presentation, Singapore–Malaysia ENT Meeting
2005 Best ENT Free Paper — 11th ASEAN ORL Head & Neck Congress

Areas of focus

  • Robotic ENT Surgery
  • Facial Plastics
  • Pediatric ENT
  • Sleep Apnea
  • Rhinoplasty
  • Sinusitis
  • Allergic Rhinitis
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